An observational study in Primary Health Care Providers, Early Childhood Behavior and Child Health Services, sponsored by Karolinska Institutet. Enrolling by invitation at 1 site in Sweden. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-12.
Sponsored by Karolinska Institutet · Observational
The overall aim of the research project is to investigate screen habits among children (0-5 years) and their parents including nurses' perspective, and further parents' and nurses' experiences of using web-based healthcare advisory services within Swedish child health care (CHC).
The main research questions are:
What is the correlation between children's and their parents' screen use?
How does screen use differ among families with various socioeconomic backgrounds?
How well does the modified SCREEN-Q instrument measure screen use in Swedish conditions?
How do parents perceive their own and their children's screen use and their parental role?
What are parents' views on available advice and recommendations regarding children's screen use?
How do parents use and experience web-based advisory services within health care and Swedish child health care (CHC)?
How do CHC nurses address screen media-related issues within CHC?
What are CHC nurses' experiences with web-based advisory services?
Participants will:
This study investigates screen habits among children aged 0-5 years and their parents, as well as child health nurses' experiences with screen-related guidance and digital health advisory services within Swedish Child Health Care (CHC). The study is grounded in the WHO framework on social determinants of health (1), recognizing that screen use is influenced by individual, familial, and societal factors.
Study Design and Methodology:
A mixed-methods design is employed. The quantitative component consists of a cross-sectional survey (N=300) using a modified version of the SCREEN-Q instrument (2), adapted for Swedish conditions. Psychometric validation will include translation/back-translation, expert review, pilot testing, factor analysis, and reliability testing (Cronbach's alpha). Data will be collected digitally and via paper forms through local Child Health Care centers across three regions in Sweden.
The qualitative component includes two semi-structured interview studies with parents (N=10-15 per sub-study) and focus group discussions with child health nurses (N=15-24 total). These will explore attitudes toward screen use, perceptions of parental roles, and experiences with digital health services. Interviews and discussions will be recorded and transcribed for analysis.
Data Management and Quality Assurance:
All survey data will be stored in REDCap at Karolinska Institutet, locked by passwords. Paper surveys will be stored in locked cabinets. Data validation procedures include automated range and consistency checks. Manual review will be performed for flagged entries. A data dictionary will be developed for all variables, including coding schemes and definitions.
Source data verification will be conducted by comparing survey responses with recruitment logs and consent forms. No external medical records will be used.
Within the project there will be step-by-step procedures to guide how participants are recruited, how informed consent is collected, and how data is gathered, entered, and analyzed. These procedures will also include instructions for handling any unexpected changes in the study or any other issues that may arise.
Sample Size and Statistical Analysis:
A sample size of 300 was determined based on a medium effect size (Cohen's d = 0.5), α = 0.05, and power = 80% (3), sufficient for psychometric validation and subgroup analyses.
Quantitative data will be analyzed using SPSS. Analyses include descriptive statistics, t-tests, ANOVA, chi-square tests, and regression analyses to examine relationships between screen use and background variables. Psychometric validation will include exploratory factor analysis and reliability testing.
Qualitative data will be analyzed using Thematic/content analyses to identify themes and patterns related to screen use and digital health service experiences.
Missing Data Plan:
Missing data will be handled using multiple imputation techniques for quantitative analysis. For qualitative data, incomplete transcripts will be excluded from thematic coding. All procedures will follow ethical guidelines and data protection regulations.
224 studies on the registry are indexed under Child Behavior; 41 are open to participants now.
This study's planned enrollment of 320 is above the median of 100 across 25 observational studies indexed under Child Behavior.
Browse Child Behavior studies →Karolinska Institutet is the lead sponsor of 1,148 studies on the registry; 276 are open to participants now.
Counted across the registry records on this site, refreshed daily.
The study population for the cross-sectional (qualitative part of the project) consists of:
-Parents or primary caregivers of children aged 0-5 years who are enrolled in Child Health Services in Sweden. Participants will be recruited from child health service units located in at least three different regions, including both urban and rural areas, to ensure diversity in geographic and socioeconomic backgrounds.
Later part of the project includes parents for the same population for qulitative studies. Nurses working in these regions will also be included in the qualitative part of the study to provide professional perspectives on screen use and digital health services.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Parents' screen use
Parents are asked about following in SCREEN-Q (modified): Primary place of work or study, Time spent on screen-based work tasks at home on weekdays and weekends, Time spent on screen-based leisure activities on weekdays and weekends, Types of screen-based leisure activities,
Time frame: Day 1
Child's screen use
Parents are asked about following in SCREEN-Q (modified): Child's Access to Screens, Child's Use of Screen Devices, Child's Ownership of Screen Devices, Time Spent on Screen-Based Activities, Screen Media Habits at Home, Rules for Screen Use, Screen Use During the Day, Multitasking and Social Context of Screen Use, Parental Perceptions of Child's Screen Use, Age When Child Received Own Devices
Time frame: Day 1
Demographic background factors: quantitative study about screens
Parents are asked: Age, Gender, Number of children, Age of the child, Family situation, Educational background, Country of birth, Time living in Sweden, Employment status, Relationship to the child, Number of people in the household
Time frame: Day 1
Themes identified through semi-structured interviews on parental reasoning and attitudes about screen use
This outcome will be assessed using semi-structured interviews with parents. Interviews will be transcribed and analyzed using thematic analysis or content analyses. The analysis will explore parental motivations, beliefs, and contextual factors influencing screen use. Findings will be reported as descriptive thematic categories. Unit of Measure Emergent qualitative themes/categories
Time frame: Day 1
Themes identified through interviews on parental perceptions of screen-related guidance and recommendations
This outcome will be assessed through semi-structured interviews with parents, focusing on their perceptions of professional guidance and recommendations regarding children's screen use. Transcripts of audio-recorded interviews will be analyzed using thematic/content analysis to identify key themes such as clarity, usefulness, and trust in guidance received. Unit of Measure: Emergent qualitative themes/categories
Time frame: Day 1
Demographic background factors for qualitative interviews about digital advisory services
Demographic background factor are asked at the time of interview : Parents: Age, Gender, Number of children, Age of the child, Family situation, Educational background, Country of birth, Time living in Sweden, Employment status, Relationship to the child
Time frame: Day 1
Themes identified through interviews on parents' experiences with web-based advisory services
Semi-structured interviews will be conducted with parents to explore their experiences using digital advisory services related to screen use. The audio-recorded interviews will be transcribed and analyzed using thematic analysis or content analyses to identify themes/categories related to accessibility, relevance, satisfaction, and barriers to use. Unit of Measure: Emergent qualitative themes/categories
Time frame: Day 1
Demographic background for focus group discussions with nurses
Nurses: Age, Gender, Region of Employment, Years of Experience as a child health nurse, employment Percentage in Child Health Services, Specialist Education
Time frame: Day 1
Short questionnaire about nurses' working methods before focus group discussions
Following areas are covered in the short questionnaire: Focus areas, Guidelines used, Knowledge level, Confidence level, Training received, Discussion challenges, Support needs, Regional policies, Training frequency, Experience impact, Trust influence, Web advisory use
Time frame: Day 1
Themes identified through focus group discussions with nurses regarding current screen use of families
This outcome will be assessed through focus group discussions with nurses. Discussions will be audio-recorded and thematic analysis/content analyses will be used to identify themes/categories related to current practices, challenges, and strategies in advising families about screen use. Unit of Measure: Emergent qualitative themes/categories.
Time frame: Day 1
Plan to share: No — Individual Participant Data (IPD) will not be shared for this study/project. The data include sensitive information about young children and their families, and despite anonymization, there remains a risk of re-identification, particularly in small or region-specific samples. Furthermore, the informed consent obtained from participants does not include provisions for broad data sharing, and ethical approval for such sharing has not been granted.
Started Feb 2026 (actual). Primary completion is estimated for Dec 2029, 46 months after the start.
How these figures are worked out, and which studies are left out of them.
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
No contact was published for this record. The registry link below has the sponsor’s details.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.